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Rights and Legal Issues - Sample Crisis Plan

This web page is intended for mental health consumers interested in developing their own crisis plan. This is a sample crisis plan that can be adjusted to meet individual preferences. This page will also be of interest to mental health service providers, family members and others interested in supporting individuals in developing their crisis plan.

  • Sample Crisis Plan with Instructions (Microsoft Word*)  (Adobe PDF*)
    The purpose of this document is for you (a mental health consumer) to create a plan you and or your providers can access when you are having a hard time. The best time to work on this document is when you are doing well. While those may not be the times you want to think about crisis, it can be beneficial for you should you ever need to access crisis services in the future. You can fill this out alone or in conversation with someone else. This is simply a guide, it is YOUR crisis plan, use it however you would like. This “Crisis Plan with Instructions” may help you answer many of the questions.
  • Blank Sample Crisis Plan(Microsoft Word*) (Adobe PDF*)
    This is a blank version of the above sample crisis plan that can be used and adapted as needed.

For a free viewer or to request a hard copy

Ronalh Welch, Director

Ronald Welch, Director

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